Individual
USHA RANI MUTHYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5806
Mailing address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2010019780
MO
208M00000X
Hospitalist Physician
Primary
036138373
IL
208M00000X
Hospitalist Physician
2010019780
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396925888
—
IL
05
—
1396935888
—
MO
Enumeration date
07/31/2007
Last updated
07/28/2015
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